No abstract

The authors describe the podiatric biomechanical management of the child and adolescent with Down syndrome. They also present an overview of the genetics, general characteristics, orthopedic problems, and gait of these patients. They discuss the various approaches to the biomechanical problems associated with the syndrome, and present two case histories that demonstrate common considerations in the treatment of the patient with Down syndrome.

The authors provide a comprehensive review of the nature, origins, and natural history of torsion of the lower extremity. Norms for children and adults are discussed, along with implications for treatment.

The history and prosthetic difficulties of a patient with an unusual Chopart amputation variant have been presented. Although it is possible for the Chopart amputee to walk with just a shoe and filler, this patient does best with a formal prosthesis. The Chopart amputation, which has been surgically stabilized with Achilles tendon lengthening to prevent equinus contractures, can be fitted successfully with a lightweight circumferential plastic or silicone prosthesis or more traditionally with a solid ankle foot orthosis with filler. This partial foot prosthesis is worn with a sturdy shoe with a rocker and solid ankle cushion heel or a well constructed running shoe. The Chopart amputee with equinus contractures must be fitted with a Chopart clamshell prosthesis or solid ankle patellar tendon bearing orthosis with filler and the above shoe prescription. Recent variants of the partial foot prosthesis including the Imler partial foot prosthesis, the Lange silicone prosthesis, and the ankle corset prosthesis were described.

A rare case of lichen sclerosus et atrophicus coexisting with morphea in the foot was presented. Orthotic therapy was required to alleviate an antalgic gait.